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皮肤恶性黑色素瘤的临床病理特征及短期生存分析

Clinicopathological Characteristics and Short-Term Survival Analyses of Cutaneous Malignant Melanoma.

作者信息

Ullah Faizan, Jamshed Muhammad, Shakeel Osama, Khalid Uzma, Khan Romaisa, Dhanani Rahim, Mansoor Rida, Ullah Sami, Hussain Raza

机构信息

Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.

Internal Medicine, Shrewsbury and Telford Hospital NHS Trust, Shrewsbury, GBR.

出版信息

Cureus. 2020 Aug 19;12(8):e9868. doi: 10.7759/cureus.9868.

Abstract

Objective Cutaneous malignant melanoma (CMM) arises from melanocytes, which are pigment-producing cells in the skin. CMM constitutes less than 5% of all cutaneous malignancies worldwide but is associated with the highest mortality rate among all skin cancers. The objective of this study was to examine the profile of clinicopathological factors, survival analyses, recurrence rate, metastatic rates, and the management of CMM at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan. Methodology All patients with a diagnosis of CMM treated at our institute from 2014 to 2017 were included in the study. Demographic variables and clinicopathological characteristics were collected and short-term oncological outcomes were recorded. All data were entered and analyzed in SPSS Statistics version 21 (IBM, Armonk, NY). Results A total of 28 patients were included in the study. The median age of the patients was 46.5 ±15.9 years. There were 16 male and 12 female patients. A family history of melanoma was present in 7.1% (n=2) of the patients. All patients had a mean survival of 13.43 ±9.09 months. The lower limb was the most common site of tumor among all patients, accounting for 46.4% (n=13) of the cases. On histopathological analyses, ulceration was seen in 53.6% (n=15) of the patients. Unclassified tumor type was present in 75% (n=21) of the patients, followed by nodular in 21.4% (n=6), and superficial spreading in 3.5% (n=1). Clark level IV was the most common presentation, constituting 46.4% (n=13) of the cases. Metastasis was seen in 50% (n=14) of the patients. Local recurrence was observed in 60.7% (n=17) of the patients; 64.3% (n=18) of the patients were alive after one year of treatment. Conclusion CMM is a disease with very high fatality rates. Although it is a disease commonly associated with fair-skinned populations, the incidence of CMM is rising in our part of the world as well. Early diagnosis and prompt management of the disease are crucial in its treatment. However, the mortality rate associated with this disease is still not favorable.

摘要

目的 皮肤恶性黑色素瘤(CMM)起源于黑素细胞,黑素细胞是皮肤中产生色素的细胞。CMM在全球所有皮肤恶性肿瘤中占比不到5%,但在所有皮肤癌中死亡率最高。本研究的目的是调查巴基斯坦拉合尔绍卡特·汗姆纪念癌症医院及研究中心(SKMCH&RC)皮肤恶性黑色素瘤的临床病理因素、生存分析、复发率、转移率及治疗情况。方法 纳入2014年至2017年在我院诊断为CMM并接受治疗的所有患者。收集人口统计学变量和临床病理特征,并记录短期肿瘤学结局。所有数据录入SPSS Statistics 21版(IBM,阿蒙克,纽约)进行分析。结果 本研究共纳入28例患者。患者的中位年龄为46.5±15.9岁。男性16例,女性12例。7.1%(n=2)的患者有黑色素瘤家族史。所有患者的平均生存期为13.43±9.09个月。下肢是所有患者中最常见的肿瘤部位,占病例的46.4%(n=13)。组织病理学分析显示,53.6%(n=15)的患者有溃疡。75%(n=21)的患者肿瘤类型未分类,其次是结节型,占21.4%(n=6),浅表扩散型占3.5%(n=1)。克拉克四级是最常见的表现,占病例的46.4%(n=13)。50%(n=14)的患者发生转移。60.7%(n=17)的患者出现局部复发;64.3%(n=18)的患者在治疗一年后存活。结论 CMM是一种死亡率极高的疾病。尽管它通常是一种与白种人相关的疾病,但在我们这个地区CMM的发病率也在上升。该疾病的早期诊断和及时治疗对其治疗至关重要。然而,与这种疾病相关的死亡率仍然不容乐观。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c93a/7500743/89938be16d52/cureus-0012-00000009868-i01.jpg

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